Multiple peptide hormone producing adenocarcinoma of lung with neurotensin and CRF-like immunoreactivity

A pulmonary cancer of a 43 year-old-man was classified according to WHO-criteria as a poorly differentiated adenocarcinoma because of demonstration of mucinous substances in tumor cells and in rarely occurring acinar lumina. Immunohistochemical reactivity for several peptide hormones was detected in the predominant solid parts of the carcinoma. In many tumor cells an immunoreactivity to neurotensin, bombesin and - according to the elevated serum levels - to ACTH, CRF and calcitonin was found. Therefore the present lung cancer must be defined as a combined carcinoma composed of mucous producing and endocrine cell types. Because peptide hormone production is not restricted to the classical "neuro"-endocrine lung tumors, the histogenesis of this heterogeneous lung cancer is discussed.